Life and Limb (6 page)

I
t was the view that cost the money. Not the ingredients of the no-frills sandwich that consisted mostly of rocket and mayonnaise. Well, all right, Dicte conceded. It
was
nice beside the open river, munching away and staring at the crowd of people promenading by the water's edge. You paid for the atmosphere.

‘Ten minutes?'

Bo slipped unbidden onto the chair opposite. He seemed as excited as a child on the way to a fun fair.

Dicte checked her watch. ‘I have to be at the IFM in forty-five minutes, but fire away,' she mumbled with food in her mouth. His enthusiasm was contagious and her heart began to race.

‘I've been e-mailing my colleague in southern Europe. Janovich. He works for a magazine which translates as
Weekly Round-Up
.'

‘In Kosovo, you mean? And?'

He nodded and took a sip of water from her glass.

‘Kosovo, of course. On the fifth of March 2005 they found the body of a young Albanian journalist, Janet Rugova, by the Gradski Stadium in the middle of Pristina. It was assumed that she had been killed by Serbian nationalists tired of her articles about a Kosovo for Albanians.'

Bo pinched a leaf of rocket from her plate, ate it and grimaced at the bitter taste.

‘Albanians make up more than ninety per cent of around four million inhabitants. During the war there was a suspicion that Albanians had been massacred at Gradski Stadium. The place has symbolic significance and the discovery of Rugova's body, together with other events, triggered the worst clashes between Albanians and Serbs since the end of the war. Are you listening?'

Dicte blinked. Her mind had begun to wander. Kosovo and the former Yugoslavia and dead journalists several hundred kilometres away. Had it not been for the excised eyes, she would not have seen a connection. This wasn't the first time that a body had been linked with the stadium in Pristina, either. Last night it had all sounded so obvious, as if there was a connection. But in the light of day she wasn't at all convinced that Mette Mortensen's death had anything to do with a journalist's dead body found in Pristina two years ago.

‘Course I'm listening.'

‘The murder was never solved.'

‘But the general assumption was that it was a political act?'

Bo nodded.

A journalist who wrote provocative articles had to be an obvious target.

‘Does anyone know what she was working on?'

That was the kind of crime they could understand, Dicte thought. The type of murder that had some logic, however repugnant that might sound. Anything else didn't bear thinking about. A random, unmotivated death.

Bo shook his head.

‘I asked that, too. Janovich is a good friend of Janet Rugova's brother, who also works as a photographer. Apparently she wasn't working on anything explosive.'

‘How did she die?' Dicte asked.

Bo leaned towards her.

‘The cause of death was a blow to the head. But it wasn't just that her eyes had been taken out. Someone had also removed the bones in her legs and replaced them with PVC piping.'

Paul Gormsen was away, so it was the new forensic examiner, Hanne Fridtjof, who patiently explained the rules and clarified why additional examinations of samples from the body would take time.

‘We understand how the relatives must feel,' said the young examiner. ‘It's hard when you can't bring closure to a case, but we have to appeal for patience. We're still waiting for the results of some tests.'

She emphasised that she could not make any detailed comments about individual cases.

‘By and large, all deaths have to be reported to the police for a coroner's inquest. The body is released to the relatives as soon as possible, usually the day after a post-mortem has been performed. In those cases it's the police who determine whether or not the body can be given up for burial and that can happen even though we haven't determined the cause of death.'

‘But you keep looking?' Dicte asked.

Fridtjof nodded.

‘We take relevant samples for investigation under a microscope, such as from the heart's electrical system and brain tissue to check for epilepsy and carry out other forensic examinations.

They were sitting in the pathologist's office in the old Aarhus Kommunehospital. The building, overgrown with ivy, was situated across from the emergency medical service on the other side of the hospital's main thoroughfare. It was the last chance to visit the old institute. In a few months the Institute of Forensic Medicine, and the Forensics department – which was at the psychiatric hospital in Risskov – would move to a completely new building in Skejby Hospital.

‘So it's the labs that are responsible for the delay,' Dicte said. ‘I suppose the demands made on them have increased?'

Fridtjof nodded.

‘It's tight.'

‘And on top of that there's the mutilated body from the stadium,' said Dicte, taking a risk. ‘Were her bones replaced with PVC pipes?'

The pathologist nodded again.

‘A terrible business. Poor parents.'

Dicte gasped. The walls of the room began to spin as the consequences flooded in on her. Two identical murders. One two years ago in Pristina. One now in Aarhus. A thirty-five-year-old journalist and a twenty-two-year-old trainee accountant from a comfortable Aarhus home and without, on the face of it, any connections to criminal circles or the world outside Denmark. Two women who apparently had only one thing in common: their killer.

Dicte rose to her feet and took her leave before Fridtjof discovered that she had let the cat out of the bag. As she headed to the city centre she could see Aarhus bathed in sun from an almost cloudless sky, and outwardly everything breathed tranquillity.

Eyes cut out. PVC pipes instead of bones. Did that kind of thing really go on here in Aarhus, the city of smiles?

T
he man on the operating table looked alive, although he was clinically dead.

His skin was still warm and retained that indeterminable inner glow that separates the living from the dead. His heart was still beating: the respirator was keeping it going.

He was a handsome man – or, rather, he had been. His body was well-proportioned and slim; it appeared to be moulded by a type of sport that didn't build up excessive muscle. Running, possibly, thought Dr Kempinski, who, despite his foreign name, considered himself Danish to the core. His parents had fled Hungary in the 1950s and he had been born and bred in Denmark.

For a moment Janos Kempinski gazed at the man on the operating table with respect. Such a perfect body and such a loss; organ donation was quite a gesture. Yesterday the man's car had crashed somewhere between Aarhus and Viborg when he had lost control and driven straight into a tree by the roadside.

Kempinski took a deep breath in the neurosurgery operating theatre at what had once been called Aarhus Kommunehospital. He compared, and not for the first time, the atmosphere with that of a religious ceremony – not that he had any kind of personal faith; he had rejected religion in favour of science long ago. But still he welcomed the notion of the ritual, of holding something sacred, and in his world this was the Holy Grail: fresh, healthy organs which could save the lives of six people.

As always, the number of people present in the operating theatre seemed extreme, but the fifteen masked figures knew how to move around one another with purpose.

Right now, however, they were waiting. They were waiting for him. The kidney surgeon always started, and he was also the one to close up when everyone else had taken what they came for.

Kempinski received the go-ahead from the theatre nurse and went to work with the utmost care. He exposed all the organs. Then he clamped the aorta and the man's heart stopped. It was not until then that the respirator was switched off. He made way for the thoracic surgeon, Dr Ture Hansson, who had travelled from Oslo to collect the heart. Hansson worked fast and efficiently. The term ‘hands of a surgeon' were truly apt here: long and elegant and possessing remarkable precision, they removed the man's heart – albeit with a modicum of swearing and cursing. With an irascible temperament, Hansson lived up to the stereotype of thoracic surgeons.

The time constraints, however, were daunting – within four hours this heart would hopefully be beating in another man's chest.

From then on it was like a military operation in which everyone knew his or her roles. The lungs were removed, followed by the liver. One by one the surgeons disappeared with their pickings. In the end only Kempinski and his colleague, Torben Smidt, remained together with the two nurses who had attended from Skejby Hospital.

Few words were spoken and they were often monosyllables. This was not the place for banter or bad jokes. Words such as ‘clamps' and ‘suture' and ‘scalpel' received the most hits. ‘Thanks' was also heard frequently.

When he finally held a kidney in his hand Kempinski rinsed off the blood and placed it in a small box in which a constant temperature of five degrees Celsius ensured that the organ would stay fresh for up to thirty-six hours before it was inserted into another human being.

Kempinski looked at Smidt, who had removed the second kidney. They nodded to each other and then Smidt left, with both organs boxed up, for Skejby Hospital.

Kempinski closed the man's chest, assisted by the theatre nurse. Unlike his appearance at the start of the operation a few hours earlier, the man on the operating table no longer looked alive.

When Kempinski left the operating theatre shortly afterwards it was with a feeling of satisfaction. Everything had gone without a hitch. The organ donor's blood would now be crossmatched with that of the recipient. If all went well, he would be able to use one of the kidneys tomorrow.

This job was his life. This place was where he felt alive. He got a buzz from the adrenaline pumping around his body.

In the car on his way to Skejby Hospital he happened – quite unfairly – to compare the highlights of his work with that morning's sexual exploits.The woman who was currently granted access to his bed was named Annelise, and he decided then and there that they had been together for the last time. It wasn't her fault; it was his. His capacity for passion appeared to be exhausted by surgery and he had long since abandoned hopes of a great romantic encounter with ‘the one'. He had his work and, at regular intervals, he would take a mistress who didn't demand too much of him. Surely he could be content with that?

He walked down the corridor to his office and pushed open the door, unprepared for resistance. The woman was standing right behind it. She was holding a stack of files in her arms and when he collided with her the files pitter-pattered to the ground, one by one. ‘Oh, sorry. My fault.'

He bent down to help.

‘No, no, mine entirely, I'm sure. I'm so clumsy. I just wanted to …'

She squatted down alongside him. She smelled of lemon or something equally fresh and appealing, so different from the smell of blood and disinfectant in the operating theatre. She was slender and looked like a little girl as she sat on the floor hugging the folders. Her hair was piled up in a messy bun. Her lips quivered as if she were on the verge of tears. And her eyes – he had never seen eyes that colour before.

‘Lena Bjerregaard.'

Kempinski took her elbow and helped her to stand up.

‘I'm the new secretary,' she continued. ‘Maternity cover.'

He had forgotten. As he forgot so many things he considered insignificant. He cleared his throat.

‘Janos Kempinski. Oh, and welcome to our department.'

They were green or maybe they were blue with a hint of sea and seaweed and sunshine. They caused every other thought to drain from his mind.

‘Thank you, that's kind of you … Dr Kempinski.'

‘Janos,' he corrected. ‘We're on first-name terms here.'

‘Janos,' she repeated tentatively, as if finding it inappropriate.

He gulped. Even the tone of her voice was enough to send goose pimples across his flesh. It was so girlish, so vulnerable and so alive. The man on the operating table suddenly seemed very far away.

For a while they struggled with small talk, which had never been his strong point. Then she came to his rescue and led him through a minefield of conversational pitfalls so he avoided giving the impression that he was a total idiot. She apologised for starting her new job by taking time off but, she explained, she had an appointment with an eye specialist the next morning at ten and everyone knew that such appointments had to be booked six months in advance, at least.

‘Of course. That's quite all right,' he said, even though decisions of this kind were not his to make.

‘I can stay late to make up for it,' she offered.

‘I won't hear of it,' he said.

‘Thank you.'

She was originally from Odense, she told him, and had lived in Aarhus for ten years. She had started studying Danish at the university, except rising unemployment figures for arts graduates had scared her off and she had switched to a business course.

It was something completely different that scared him: a sudden fear that she might not reappear the following day. That he might never see her again.

Kempinski tore himself away with difficulty. Heading down the corridor to the dialysis ward, whistling, he felt a hot flush wash through his body and he decided that he had generated sufficient energy to visit the Special Patient, as he had named him.

Normally he had very little contact with his dialysis patients, but he had taken an interest in this particular patient right from the start, possibly because the man's exceptional circumstances had aroused his curiosity.

The Special Patient's name was Peter Boutrup. He was twenty-nine years old and had come from the new East Jutland State Prison – where he was serving a sentence for involuntary manslaughter – to receive dialysis treatment at the hospital. It had so far proved impossible to determine the cause of his kidney failure, but the situation was critical. If he didn't receive a new kidney very soon, there would be nothing anyone could do for him.

Kempinski continued to whistle as he made his way. ‘We Are the Champions' was one of his favourite tunes, although the notes proved difficult to hit with any degree of accuracy.

The case of Peter Boutrup had challenged his moral values from the start. It had in fact prompted – in the strictest confidence, of course – a debate among his colleagues on the question of priority and, as always, Kempinski was the first to represent the voice of reason – insofar as that was possible. His colleague Torben Smidt was the opposite. He enjoyed stirring things up.

‘Assuming that a kidney is a good tissue match for several patients, who should receive it?'

This discussion had followed in the wake of the arrival of the Special Patient in a prison van accompanied by two police officers who sat on either side of his bed.

The question was essentially hypothetical as a computer usually determined which of the patients on the waiting list would be the most suitable recipient. It was rare for major humanitarian or ethical considerations to apply, because if two potential recipients were equally suitable and of the same sex, age and build, it was the length of time they had been waiting that would decide the outcome. The only exception was children, who always took priority.

‘Take an unemployed immigrant, the Special Patient from East Jutland State Prison and an ordinary tax-burdened Dane with a steady job. Which one gets the kidney?'

Torben Smidt had shot him a provocative look.

‘It's our choice,' he had stressed. ‘It's up to us. To you.'

In truth, the question was impossible to answer.

‘The fact that one is an immigrant, the other a convicted killer and the latter a pillar of society is irrelevant,' Kempinski had argued. ‘The question is: who is the most suitable recipient for this particular kidney?'

‘But what if they're equally suitable? Or equally unsuitable?'

‘But that's impossible.'

‘But what if …'

And so they continued to chase each other through the labyrinths of ethical dilemmas.

‘I suppose you would have to draw lots,' Kempinski eventually said, sighing at length.

Smidt had looked disappointed.

‘Isn't that a cop-out? Don't you think we should face the issue head-on and be prepared to prioritise?'

‘We can only prioritise on the basis of medical considerations. It's not our job to make wide-reaching social decisions on the basis that those who have contributed most to society should be the first in line,' he'd said.

Smidt had shaken his head.

‘No, by all means, why don't we leave it to chance?'

‘It's the fairest way.'

‘Not in terms of outcome.'

Perhaps it had been the tone in Smidt's voice – for once Kempinski was overcome by genuine concern.

‘I sympathise, I do. But this kind of thinking is a slippery slope.'

Smidt had got up from the canteen table with his usual mischievous smile playing on his lips.

‘That may well be. But one day we'll have to face that decision. Or a personal dilemma of a similar nature. When that happens it'll be interesting to see if theory and practice turn out to be one and the same.'

Kempinski pushed the issue aside as he approached the side ward to which the Special Patient had been allocated. He tapped on the door lightly and pushed it open. Peter Boutrup was lying in bed, looking weak. His shoulder-length blond hair stuck to his scalp and his otherwise muscular body had shrunk since Kempinski had last seen him. Boutrup's skin and overall appearance seemed dulled. Only his blue–green eyes shone with a rare intensity and a not-entirely-friendly smile curled at one corner of his mouth.

‘Good afternoon, Peter. How are you?'

The eyes met his. The lips started to form the words that came out like dubbed speech in delayed time.

‘How am I, do you think?'

Kempinski pulled up a chair and sat down. Once again he had to bow to the man's contempt for death, which radiated from him as it had done right from the start.

‘And you haven't remembered a relative who may want to donate a kidney to you?'

The man's lips drew over his teeth in a parody of a smile.

‘Now listen to me, Dr Death: I've told you, I have no family.'

Kempinski shrugged. Yet again he marvelled at his own fascination with this obstinate patient.

‘You must have
some
family. Perhaps they're more supportive than you imagine. The hospital could contact them and invite them in for a chat.'

The man bared his teeth, now in a low snarl. Kempinski was reminded of his cat as it lay dying – it too had retained the energy to hiss.

‘Give a kidney to a prisoner? To a man who has killed another man? How naive do you think I am?'